Aimee 上海某医院
80-year-old woman with frontal bone mass
80岁老年女性,额骨肿块
History: An 80-year-old woman presents for resection of a long-standing transosseous mass of the right frontal bone. The patient has no history of malignancy.
病史:80岁老年女性,手术切除右侧额骨跨骨肿块。患者无恶性肿瘤病史。
Preoperative and postoperative noncontrast-enhanced CT images, including one in bone window, are shown below. Click to enlarge.
下图为术前及术后平扫CT图像(包含骨窗)。点击放大
Findings
影像学表现
· Preoperative CT: Axial CT image demonstrates a trans osseous mass in the right frontal bone.
· 术前CT:横断面CT可见右侧额骨跨骨占位
· Postoperative CT: Axial and coronal CT images demonstrate postsurgical changes of right frontal craniotomy with resection of the mass. There is a large, left cerebellar hemispheric hemorrhage with part of the hemorrhage along the cerebellar folia.
· 术后CT:横断面积冠状面CT可见右侧额骨肿块切除术后改变。可见左侧小脑半球较大面积出血,部分沿小脑镰分布。
Differential diagnosis
鉴别诊断
· Hypertensive hemorrhage
· Cavernous hemangioma
· Hemorrhagic metastasis
· Hemorrhagic transformation of infarct
· Remote cerebellar hemorrhage
· 高血压性出血
· 海绵状血管瘤
· 转移灶伴出血
· 脑梗死后出血
· 远端小脑出血
Diagnosis: Remote cerebellar hemorrhage following mass resection of meningioma
诊断:脑膜瘤切除术后(病灶)远端小脑出血
Remote cerebellar hemorrhage (RCH)
远端小脑出血
· Remote cerebellar hemorrhages are uncommon complications of supratentorial craniotomies. The term remote refers to the location of the hemorrhage distant from the craniotomy site.
· 远端小脑出血属于罕见的幕上手术并发症。“远端”一词是指出血离术区距离较远。
· The underlying pathophysiology is not well understood, but it is thought to be due to the occlusion of veins in the posterior fossa and subsequent hemorrhagic infarction.
· 病理病生机制未知,可能是和后颅窝静脉栓塞及继发的梗死性出血相关。
· Patients most commonly present with altered mental status. They may also experience delayed awakening from anesthesia.
· 患者常表现为精神状态改变,并可能出现麻醉后延迟苏醒。
· In the proper clinical setting, this diagnosis should be considered. The clinical course of remote cerebellar hemorrhage tends to be benign in contradistinction to other causes of intracranial hemorrhage.
· 在特定的临床情况中,需要考虑该诊断。和其他原因引发的颅内出血相比,远端小脑出血的转归一般较好。
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